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Organization
ANCIENT HEALING ORIENTAL MEDICINE CLINIC S.C.
Active
Organization
ANCIENT HEALING ORIENTAL MEDICINE CLINIC S.C.
Active
Other names
Ancient Healing OMC s.c.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WIOLETTA BORECKA-KOLCAN MD, OMD, L.AC. (PRESIDENT)
(773) 562-0734
Entity
Organization
Contact information
Practice address
987 OAK KNOLL DR., LAKE FOREST, IL 60045-2635
(847) 735-9609
(847) 235-2439
Mailing address
987 OAK KNOLL DR, LAKE FOREST, IL 60045-2635
(847) 735-9609
(847) 235-2439
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
03801172
IL
261Q00000X
Clinic/Center
Primary
198.000814
IL
261Q00000X
Clinic/Center
198000814
IL
Other
Enumeration date
06/11/2009
Last updated
01/25/2011
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